State Auditor: Mississippi may be paying millions to ineligible Medicaid recipients
Aug. 2—TUPELO — Around 5% of Medicaid recipients in Mississippi could be ineligible to receive benefits from the program because of their income, according to a report released on Monday by State Auditor Shad White.
As a part of its annual audit of federal funds that flow through state agencies, auditors this year compared the income that Medicaid recipients reported to the Mississippi Division of Medicaid with the income that the recipients listed on their state income tax returns.
"The use of these returns to figure out if people are lying to obtain benefits started last year in my office," White said. "We now have enough data to show there are millions of dollars of potential savings if we can prevent ineligible people from getting on Medicaid. The benefits should only be going to those who deserve to be on the program."
The audit conducted a sample of 180 different Medicaid beneficiaries and concluded that around nine of the recipients could be ineligible due to the high levels of income reported.
White said he found evidence of at least two Medicaid recipients living in multi-million dollar homes, but these two individuals were already under investigation by Medicaid leadership. The two individuals were not part of the audit's overall Medicaid sampling.
Logan Reeves, the spokesperson for the auditor's office, later told the Daily Journal that State Auditor's Office estimates that the 5% of the people estimated to be ineligible for Medicaid benefits make about $10,727 on average more than the legal income threshold needed to receive Medicaid benefits.
Even though 5% can be viewed as a marginal number of overall recipients, White's office estimates that the state could save millions of dollars if the state screened the tax returns of the beneficiaries beforehand.
However, in a response contained within the auditor's report, the Division of Medicaid warned that past tax returns may not reflect current income levels. That means individuals who were not eligible in recent years for the program may not be lawfully eligible.
According to its response, the Medicaid Department "is required to base eligibility on current income and family size for new applicants and current beneficiaries. The tax information used by OSA in its audit procedures is from a time period more than a year prior to the application for eligibility determination. Financial information that far out of date may not accurately reflect the current circumstances of applicants."
The Mississippi Legislature recently gave the state auditor's office the authority to review state tax returns when conducting audits.
The state Division of Medicaid, however, currently does not have the legal authority to obtain state income tax returns to compare to the income claimed by Medicaid applicants when they apply for the program.
White recommended that state lawmakers change the state law to give leaders in the Division of Medicaid the authority to review tax returns to prevent ineligible recipients from receiving state and federal benefits.
"We know this tool would be useful because Medicaid's internal policies state they should ask an applicant for their return, but without the authority to get the return and a requirement to use it, the state is potentially handing out millions to ineligible people," White said.
The report also questioned around $10 million in federal funds that the Mississippi Department of Human Services spent this year. White said that some of the spending includes things such as questionable advertising.
